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How to Avoid Claims Denials and Rejections of Your Medical Electronic Billing

Although we have benefited from using electronic medical billing, we should not think that the task is a simple one. But, if you are trained and if you practice the ways to efficiently maximize the use of electronic submission, then it will ensure that your claims submissions will not encounter any hindrances. Electronic medical billing has a lot of benefits. Compared to paper billing which takes weeks to complete, electronic medical billing take only around 3 days to process and reimburse payments. It reduces errors and lost claims almost completely. There is full encryption of transmissions and it is compliant with HIPAA rules and guidelines.

If you have an electronic medical billing system in your facility, it is important that you sign up with a clearinghouse that charges a reasonable monthly flat fee regardless of how many claims you can submit and resubmit. You should not pay any other fees on top of that flat fee. The clearing house should also be compliant with HIPAA rules and regulations. There is no trouble looking for a good clearing house to use for your electronic medical billing submissions.

Make sure that you list down all of the numbers of your payor that you bill and participate with. This payor number will identify where your claims will go based on the patient’s insurance information. Make sure that your tax number is in your billing system.

When you enter your patient’s information, make sure to have the patient’s insurance ID number entered correctly. Simply put the numbers without any other characters. Asterisks and dashes should not be used.

Verify coverage for the patient for that date of service.

When you use modifiers, make sure that you are using the proper ones. Errors are easily picked up by electronic billing systems. Non-numeric modifiers use big letters.

Preview all the claims when creating the file. Check for missing information before submitting your file electronic ally. Claims should be edited so that there will be no errors. Then submit your file.

After submitting he claims, generate reports. The report should indicate that the claims are accepted. IF the generated report says that the claim is rejected, immediately call the insurance company, then resubmit your claims. when you generate receipts and reports, make sure that you read them all.

Keeping track of your claims should always be done. You have a powerful tool if you medical billing software has a tracer tool. You will know if your claims are still pending or still unpaid. You have to be persistent in following up denied or rejected claims.

Your healthcare facility can outsource all these tasks including the follow up for denied, rejected, and underpaid claims, to an experienced company that specializes in full service medical billing.

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